The complex mechanism of the factors concerned in blood coagulation has been investigated in many ways, not least among these being a study of such factors during anticoagulant therapy, and by the use of plasma from patients treated with anticoagulant drugs in crossmixture experiments with plasma from patients having congenital coagulation defects. Earlier results from such investigations indicated a simple deficiency of prothrombin and "factor VII." It is now known, however, that Christmas factor (Douglas, 1955;Biggs, 1956;Naeye, 1957), plasma thromboplastin antecedent (Naeye, 1957), and Prower-Stuart factor (Telfer, Denson, and Wright, 1956;Hougie, Barrow, and Graham, 1957;Denson, 1958) are all reduced. Factor X* (Duckert, Fliickiger, Matter, and Koller, 1955) is also reduced early in therapy. The existence of the latter factor as a separate entity, however, has not been established, and it is probably an intermediate product of thromboplastin formation. Horder (1958) studied levels of factor VII, ProwerStuart factor, and prothrombin, together with the partial thromboplastin time, and thromboplastin generation in one case receiving anticoagulant therapy with the coumarin derivative phenprocoumon (" marcoumar"; 4-hydroxy-3-(1-phenylpropyl)coumarin).Hicks and Bonnin (1959) compared the reduction in plasma thromboplastic factors, the one-stage prothrombin time, and the two-stage prothrombin levels in several cases receiving anticoagulant therapy with different drugs, and concluded that the one-stage assay provided an adequate measure of the reduction in thromboplastic factors.The present study was undertaken in order to provide a clearer insight into the fate of specific bloodcoagulation factors during anticoagulant therapy with the drug phenindione (" dindevan "; 2-phenyl-1,3-indanedione), and to endeavour to discover by means of specific assays the contribution of individual factors to the overall effect of anticoagulant therapy.
Materials and MethodsCollection and Storage of Plasma and Serum Samples.-Blood was collected simultaneously into a clean sterile tube for the production of serum, and into 1/10 volume of 3.8% sodium citrate for citrated plasma. The clotted specimen was centrifuged after four to six hours and the serum separated and stored at 0°C. for periods of up to 10 days for the assay of thromboplastic factors; these assays were carried out in batches. Plasma was obtained by centrifuging the citrated blood at 2,500 r.p.m. for five minutes. Prower-Stuart factor assays and factor VII assays were performed within two to three hours of collection, and the remaining plasma was stored at 00 C. for periods of up to two weeks for the two-stage prothrombin determinations, which were carried out in batches.*Prower-Stuart factor has now been designated Factor X by international convention.Prower-Stuart Factor Assay and Specific Factor VII Assay.-These were performed as previously described (Denson, 1961).Assay of Serum Thromboplastic Factors.-This was carried out using the thromboplastin generation method of...